Celiac and Thyroid Diseases Linked to Higher Risk of Type 1 Diabetes, Especially in Youth: Study Shows

Conducted by Dr. Steve V. Edelman and colleagues from the University of California San Diego, the study utilized real-world data to examine whether individuals with autoimmune conditions such as celiac disease, hyperthyroidism, or hypothyroidism were more likely to develop T1D than those without these conditions.

Researchers carried out a retrospective, observational matched-cohort analysis using claims data. The study population included individuals diagnosed with one of the three autoimmune disorders and a matched control group without any of those conditions. Using a 1:1 propensity score matching method, participants were matched based on baseline demographics and clinical characteristics. The incidence of T1D was then compared between the groups using Cox proportional hazards models.

The following were the key findings:

• Individuals with celiac disease had a type 1 diabetes (T1D) incidence of 0.14%, compared to 0.06% among their matched controls.
• In the hyperthyroidism group, T1D developed in 0.17% of individuals, while only 0.06% of the control group developed the condition.
• Among individuals with hypothyroidism, 0.18% developed T1D versus 0.08% in their matched controls.
• The hazard ratio (HR) for developing T1D was 2.54 for those with celiac disease.
• For individuals with hyperthyroidism, the HR for T1D was 2.98.
• The HR was 2.41 for individuals with hypothyroidism.
• All associations were highly statistically significant.
• The data indicated that individuals with any of the three autoimmune conditions were more than twice—and in some cases nearly three times—as likely to develop T1D compared to those without such conditions.
• T1D onset occurred earlier in individuals with pre-existing autoimmune diseases than in those without.
• The elevated risk was especially evident in individuals younger than 18 years, highlighting the need for early and regular monitoring in children with autoimmune conditions.

These results emphasize the importance of early screening for type 1 diabetes in people with autoimmune diseases. Researchers suggest that testing for diabetes-related autoantibodies in these high-risk groups could facilitate early detection of stage 2 T1D—before the onset of symptoms—offering the chance to implement disease-modifying interventions and avoid serious complications from sudden onset.

The authors concluded, "The study highlights a critical overlap in autoimmune pathways and supports integrating routine diabetes screening into the care protocols for individuals with celiac disease and thyroid dysfunction."

Reference:

Edelman SV, Agardh D, Cui N, Hao L, Wieloch M, Meneghini L. Risk of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease-An observational study. Diabetes Obes Metab. 2025 Aug;27(8):4229-4238. doi: 10.1111/dom.16454. Epub 2025 May 28. PMID: 40437819; PMCID: PMC12232353.